In a health care system chiefly directed towards treating
disease and surgical intervention, the Surgeon General has
pursued a complementary strategy: disease prevention and health
promotion. Appointed by the President
with the advice and consent of the Senate, the Surgeon
General--whose title means chief surgeon--is the federal government's
principal spokesperson on matters of public health. The first
Surgeon General was appointed in 1871 to head the Marine
Hospital Service, itself established in 1798 to minister to sick
and injured merchant seamen and reorganized as the U.S. Public
Health Service in 1912. In recent decades, the Surgeon General
has become the most widely recognized and respected voice on
public health issues, preventive medicine, and health promotion
through public appearances, speeches, and, most influentially,
the reports featured on this Web site. The Surgeon General has
often been called upon to deal with difficult and controversial
issues, such as smoking and sexual health. In some cases, the
public health message has generated controversy, when it ran
counter to the political beliefs of the time. But the Surgeon
General's public statements often served to generate debate
where there had been silence, to the benefit of the nation's
health.

The role of the Surgeon General has changed much
during the past four decades. As the head of the Public Health
Service (PHS), for over half a century the Surgeon General
oversaw infectious disease eradication, rural sanitation,
medical research, the provision of medical and hospital care to
members of the Coast Guard and Merchant Marine, and other public
health activities. Until 1968, the Surgeon General's main
responsibility was the day-to-day administration of the U.S.
Public Health Service and its many programs, including directing
the uniformed Commissioned Corps of physicians, dentists,
nurses, pharmacists, sanitary engineers, and other health
professionals that has been the institutional mainstay of PHS.

In 1968, an organizational reform greatly reduced the
Surgeon General's administrative role, abolishing the Office of
the Surgeon General (though not the position of Surgeon General
itself) and transferring line authority for the administration
of PHS to the Assistant Secretary for Health within the
Department of Health, Education, and Welfare (since 1980, the
Department of Health and Human Services).
Since 1968, the Surgeon General has not administered the Public
Health Service,
and his/her main official duty has been to advise the
Secretary of Health and Human Services and the Assistant
Secretary of Health on affairs of preventive health,
medicine, and health policy.
Left with few
bureaucratic tasks, the Surgeons General since the 1960s have
undertaken a more proactive role in informing the American
public on health matters. They have relied on their professional
credentials (all Surgeons General have been MDs) and political
independence to make themselves into the most visible and, in
the public's mind, impartial and therefore trusted government
spokespersons on health issues affecting the nation as a whole.

Brief Chronology

1912 --The Marine Hospital Service is reorganized as the U.S. Public Health Service

1913 --R. J. Reynolds launches Camel, the first modern mass-produced cigarette made from blended tobacco

1917 --Cigarettes are included in the field rations of American soldiers in World War I

1957 --Surgeon General Leroy E. Burney (1956-1961) declares it to be the official position of the U.S. Public Health Service that
a causal relationship exists between smoking and lung cancer (June 12)

1968 --The Office of the Surgeon General is abolished and the position becomes that of an advisor to the Secretary of Health, Education,
and Welfare, and to the Assistant Secretary of Health. The Surgeon General no longer directly administers the U.S. Public
Health Service

1969 --The Public Health Cigarette Smoking Act passes Congress. It imposes a ban on cigarette advertising on television and radio
after September 30, 1970, and requires that the Surgeon General produce an annual report on the latest scientific findings
on the health effects of smoking

1973 --Arizona passes the first state law designating separate smoking areas in public places